During the last decade, the concept of One Health has become the international standard for zoonotic disease control. This call for transdisciplinary collaboration between professionals in human, animal and environmental health has produced several successes in zoonotic disease control, surveillance and research. Despite the lack of a clear definition, a shared agenda or institutional governance, One Health has proven to be a fruitful idea. Due to its ambiguity, the One Health concept functions as a boundary object: by leaving room for interpretation to fit different purposes, it facilitates cooperation. In many cases, this results in the promotion of health of humans, animals and the environment. However, there are also situations in which this mutual benefit of a One Health approach is not that evident, for instance, when healthy animals are culled to protect public health. Although such a strategy could well be part of a One Health approach, it is hard to understand how this contributes to the health of concerning animals. Consequently, these practices often lead to public debate. This raises questions on how we should understand the One Health concept in zoonotic disease control. Is it really about equally improving the health of humans, animals and the environment and is this even possible? Or is it ultimately just public health that counts? In cases of conflict between different values, the lack of a universal definition of the One Health concept contributes to this complexity. Although boundary objects have many positive aspects, in the context of One Health and zoonotic disease control, this conception seems to conceal underlying normative differences. To address moral dilemmas related to a One Health approach in zoonotic disease control, it is important to reflect on moral status and the meaning of health for humans, animals and the environment.
Veterinarians play an essential role in the animal-based food chain. They are professionally responsible for the health of farm animals to secure food safety and public health. In the last decades, food scandals and zoonotic disease outbreaks have shown how much animal and human health are entangled. Therefore, the concept of One Health is broadly promoted within veterinary medicine. The profession embraces this idea that the health of humans, animals and the environment is inextricably linked and supports the related call for transdisciplinary collaboration. Especially in zoonotic disease control, the benefits of the cooperation between veterinarians and human doctors seem evident. However, applying a One Health approach also makes moral problems explicit. For instance, how should veterinarians deal with situations in which measures to protect public health negatively affect animal health? This creates a conflict of professional responsibilities. To deal with such moral problems and to strengthen the veterinarian's position, the starting point is a holistic perspective on One Health. We will argue for an 'encapsulated health' argument: the best way to safeguard human health is to promote the health of animals and the environment. This also holds for the responsibility of the veterinary profession: to serve public health, the central responsibility of veterinarians should be to be experts in animal health and welfare. We elaborate this point by using a case study on the role of the veterinary profession in antimicrobial resistance policies in the Netherlands.
To tackle zoonotic disease threats, a One Health approach is currently commonplace and generally understood as an integrated effort of multiple disciplines to promote the health of humans, animals and the environment. To implement One Health strategies in zoonotic disease control, many countries set up early warning systems, in which human and veterinary health professionals cooperate. These systems, like the Dutch Zoonoses Structure, can be successful to detect emerging disease threats. However, these systems are not well equipped to handle moral dilemmas that can arise in zoonotic disease control, like the culling of healthy animals. This research studies the role of normative presuppositions of professionals involved in zoonotic disease control policies in the Netherlands. We found that these professionals in general adhered to a holistic view of the One Health concept, however, in practice an anthropocentric approach was dominant. Public health was identified as the trumping moral value, which reveals an inherent field of tension with the core of One Health thinking. The lack of ethical expertise in control systems for zoonotic diseases can lead to misconception of ethical principles, like the precautionary principle which is frequently evoked to justify disease control measures.
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